Provider Demographics
NPI:1174958375
Name:MEECE, JACLYN E (LPCC-S)
Entity type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:E
Last Name:MEECE
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:E
Other - Last Name:CRISWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:303 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2390
Mailing Address - Country:US
Mailing Address - Phone:606-677-1166
Mailing Address - Fax:
Practice Address - Street 1:303 SECOND ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2390
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
240761101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100509930Medicaid